(664) Variations in MFM Fellowship Clinical Competency through Curriculum Requirements Surpassing ACGME/ABOG Minimums by Geographic Region

To evaluate curricular differences across geographic regions for fellowship programs by assessing the variations in the distribution of specific types of rotations above the minimum core MFM requirements as defined by ACGME and ABOG.

Study Design:

This was a cross-sectional analysis of MFM fellowship curricula conducted in July 2024 for the 109 ACGME-accredited programs. All fellowship program websites were evaluated for rotation schedules. If not available online, programs were contacted via email. The total number of mandated months by rotation for each program were tallied across the three years of fellowship: supervisory L&D (min: 2 mo), inpatient/antepartum service (no minimum), outpatient MFM clinic (min: 2 mo), ultrasound (min: 3 mo), genetics/genomics (min: 2 mo), research (min: 12 mo), electives, and program-specific mandated rotations. For each rotation, the percentage of programs that exceeded ACGME/ABOG minimum duration requirements were compared across geographic regions (Northeast, Midwest, South, and West). Chi-square and Fisher’s exact analyses were performed with a p-value < 0.05. 

Results:

Rotation schedules were available for 64 (59%) of programs. The percentage of total programs that exceeded minimums were 87% for outpatient, 83% for ultrasound, 31% for research, 28% for labor and delivery, and 12% for genetics. When comparing the percentage of programs surpassing minimums by geographic region, only ultrasound requirements differed across regions (Figure 1), specifically 100% of Northeast programs exceeded ultrasound requirements versus 44% in the South (p=0.006). Twenty programs (31%) specified requirements for non-OB, non-ACGME/ABOG rotations, most frequently NICU, anesthesia, and pathology (Table 1). Of these programs, anesthesia was more frequently required in the South (p=0.013). 100% of programs offered flexible elective time.

Conclusion:

While there are curricular differences among individual MFM fellowship programs, variability above minimum requirements was only noted for ultrasound and non-obstetric rotations across geographic regions.